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<form class="f-wrap" method="post" action="<?php echo site_url('registration/reg_user'); ?>" enctype="multipart/form-data">
    <div class="indicator"><b>*</b> Indikasi kebutuhan kolom</div>
    <h3>Agensi Real Estat anda</h3>
    <?php echo form_error('perusahaan_id'); ?>
    <label for="perusahaan_id">
        <b><span class="req">*</span>Nama agensi:</b>
        <select name="perusahaan_id" id="agency_id">
            <option value="">[pilih]</option>
            <option value="8936">(Y) Pro</option>
            <option value="1004">[X]PRO Realty</option>
            <option value="12008">*Bandung Independent Agent</option>
            <option value="8">*Independent Agent</option>
            <option value="476">18 Jaya Properti</option>
            <option value="12002">1st Home Property</option>
            <option value="9596">3 in One Property</option>
            <option value="11222">5ahabat Property</option>
            <option value="3365">A &amp; J Property</option>
            <option value="5648">A1 Top Property</option>
            <option value="2366">AAA Properties</option>
            <option value="7109">AB Property</option>
            <option value="6560">Abie Property</option>
            <option value="9764">Abow Pro</option>
            <option value="47">Ace State</option>
            <option value="6887">ACommerce Property</option>
            <option value="7667">Active Homes Gading</option>
            <option value="7376">Active Homes Galaxy</option>
            <option value="881">Active Homes Harapan Indah</option>
            <option value="12089">Adastra Property</option>
            <option value="8006">ADDA Property</option>
            <option value="6854">Adira Property</option>
            <option value="11828">Agape Property</option>
            <option value="86">Agung Property</option>
            <option value="7172">Agung Property Alam Sutera</option>
            <option value="7367">Ahli Rumah</option>
            <option value="3347">Alam Bali Property</option>
            <option value="6830">Alberlin Property</option>
            <option value="7601">Alexandra Property</option>
            <option value="7847">Alfath Property</option>
            <option value="2732">AllProperty Media, PT.</option>
            <option value="11291">Alvins Property</option>
            <option value="2153">Amanah Properti Indonesia</option>
            <option value="12458">Amanah Property</option>
            <option value="233">Amartha Properti</option>
            <option value="74">Amazing Property</option>
            <option value="3218">AMNEO Property</option>
            <option value="12122">Andakara Property</option>
            <option value="677">Angels Property</option>
            <option value="11576">Anggrek Property</option>
            <option value="7424">Anugerah Bali Property</option>
            <option value="12515">Anugrah Properti</option>
            <option value="12476">Anugrah Property</option>
            <option value="4427">Apartemenkita</option>
            <option value="10307">April Property</option>
            <option value="12158">AR Property</option>
            <option value="740">Area Property</option>
            <option value="3818">ARIES Property</option>
            <option value="7982">Aries Property Management</option>
            <option value="6329">Ariyana Property</option>
            <option value="12137">Arkin Pro</option>
            <option value="5027">Arskal Zhivago</option>
            <option value="12416">Artha Property</option>
            <option value="3395">Artha Property Cibubur</option>
            <option value="3362">ARTHAMAS International Property Agent</option>
            <option value="11936">Arya Property</option>
            <option value="7676">Asa Property</option>
            <option value="8495">Ascarya Property</option>
            <option value="8471">Aset Propertindo Sejahtera</option>
            <option value="9323">Asia Enterprise</option>
            <option value="8582">Asia Home</option>
            <option value="3368">Asia Property</option>
            <option value="161">Asia Star Property</option>
            <option value="7673">ATM Properti</option>
            <option value="9653">ATM Property Gading Serpong</option>
            <option value="8690">Audrey Property</option>
            <option value="9326">AW Property</option>
            <option value="2567">Azka Graha</option>
            <option value="1916">B - CONST Real Estate &amp; Development</option>
            <option value="1238">Bakti Putra Properti</option>
            <option value="1334">Bali Elite Realty</option>
            <option value="1691">Bali Kirana Property</option>
            <option value="2357">BALI PROPERTY SOLUTION</option>
            <option value="8417">Bali Top Property</option>
            <option value="8324">Balicip Property</option>
            <option value="12608">Balimoves</option>
            <option value="9155">Balindo Realty</option>
            <option value="3179">Balindo Realty Lingkar Selatan</option>
            <option value="9797">Bamboo Property</option>
            <option value="3821">Bandana Property</option>
            <option value="8579">Bandung Land Property</option>
            <option value="12350">Bandung Pro</option>
            <option value="1922">Bandung Realty</option>
            <option value="10121">Banjar Property</option>
            <option value="6893">BaseCamp Home</option>
            <option value="12329">Batavia Realty</option>
            <option value="8816">Be One Property</option>
            <option value="6824">Be One Realty PIK</option>
            <option value="10313">Be Star Property Agent</option>
            <option value="1526">benhokk property</option>
            <option value="12470">Berau Properti</option>
            <option value="530">Berdikari  BSD Property</option>
            <option value="3059">Berdikari Alam Sutera Property</option>
            <option value="6944">Berdikari Gading Serpong</option>
            <option value="11909">Best Home Properti</option>
            <option value="602">Best Serpong Properti</option>
            <option value="7409">Bestindo Property</option>
            <option value="6551">BESTLINK Property</option>
            <option value="10712">Bhavana Indonesia</option>
            <option value="12524">Bianka Property</option>
            <option value="10697">BIG Property</option>
            <option value="11264">Bintang 78 Property</option>
            <option value="12341">Bintang Timur Property</option>
            <option value="9257">BJ-Pro Realty Bandung</option>
            <option value="4217">Blaze House Gading Serpong</option>
            <option value="7832">Bless Home</option>
            <option value="12107">Bless Property</option>
            <option value="9941">Blessed Property Pakubuwono</option>
            <option value="605">Blessed Property Tebet</option>
            <option value="8678">Blessing Property</option>
            <option value="7772">BleSSingLand Property</option>
            <option value="9806">Blooming Home</option>
            <option value="11567">BMP Property</option>
            <option value="2120">Bogor Property</option>
            <option value="2954">Boss Properti</option>
            <option value="236">Boutique Home &amp; Property</option>
            <option value="12209">Bravo Property</option>
            <option value="782">Breton Property</option>
            <option value="7556">Bridge Property</option>
            <option value="12215">BRIGHTON CBD</option>
            <option value="8609">BRIGHTON Citraland</option>
            <option value="9602">BRIGHTON Graha</option>
            <option value="11204">BRIGHTON Karawaci</option>
            <option value="8147">BRIGHTON Manyar</option>
            <option value="12407">BRIGHTON Pakuwon City</option>
            <option value="9605">BRIGHTON Satelit</option>
            <option value="1028">Brilliant Property</option>
            <option value="12596">BroLand Property</option>
            <option value="764">BSM Property</option>
            <option value="10073">BSP</option>
            <option value="2117">Bumi Citra Satria</option>
            <option value="1883">Bumi Darussalam Madiun</option>
            <option value="9500">Bumi Property Agent</option>
            <option value="2597">Bunga Property</option>
            <option value="9332">C-Pro</option>
            <option value="6713">C129 Property</option>
            <option value="2270">Cahaya Pesona Anggrek</option>
            <option value="7310">Cakra Property</option>
            <option value="12479">Capasia Property</option>
            <option value="12116">Captain Property</option>
            <option value="7133">Caraka Property</option>
            <option value="5051">Casa Gading Property</option>
            <option value="9656">Casa Property Surabaya</option>
            <option value="9284">Casabali Realty</option>
            <option value="3371">CASATERRA Property Kelapa Gading</option>
            <option value="8726">CASATERRA Property Sunter</option>
            <option value="8636">Catra Property</option>
            <option value="8195">Cava Property</option>
            <option value="11450">Cellcon Gading Property</option>
            <option value="2606">Centra Karama</option>
            <option value="164">Centra Metropolis</option>
            <option value="104">centra property</option>
            <option value="1136">Centra'77</option>
            <option value="7490">Central Auto Pro</option>
            <option value="7964">Central One Property</option>
            <option value="149">Central Plus Property</option>
            <option value="12461">Centro Property</option>
            <option value="11558">CENTRO Realty</option>
            <option value="5867">Century 21</option>
            <option value="8237">Century 21 Abadi</option>
            <option value="1586">Century 21 Akasia</option>
            <option value="6395">Century 21 Ambassador</option>
            <option value="737">Century 21 Avenue</option>
            <option value="2147">Century 21 Axel</option>
            <option value="9092">Century 21 Batanghari</option>
            <option value="6296">Century 21 Boulevard</option>
            <option value="11837">Century 21 Bright</option>
            <option value="9296">Century 21 Centro</option>
            <option value="140">Century 21 Emerald</option>
            <option value="6692">Century 21 Famaco</option>
            <option value="8168">Century 21 Family</option>
            <option value="7112">Century 21 Fortuna</option>
            <option value="1418">Century 21 Gading</option>
            <option value="209">Century 21 Global</option>
            <option value="35">Century 21 Gracia</option>
            <option value="6365">Century 21 Graha</option>
            <option value="8225">Century 21 Heavenly</option>
            <option value="5849">Century 21 Infinity</option>
            <option value="6077">Century 21 Kencana</option>
            <option value="9386">Century 21 Laguna</option>
            <option value="26">Century 21 Liberty</option>
            <option value="6794">Century 21 Manhattan</option>
            <option value="365">Century 21 Mediterania</option>
            <option value="8246">Century 21 Mediterania 2</option>
            <option value="12404">Century 21 Mediterania 5 Bandung</option>
            <option value="8645">Century 21 Mega</option>
            <option value="860">century 21 metro 2 tambun</option>
            <option value="416">Century 21 Metro 3</option>
            <option value="6779">Century 21 Nagamas</option>
            <option value="8528">Century 21 Optimal</option>
            <option value="107">Century 21 Pertiwi</option>
            <option value="6074">Century 21 Pinangsia</option>
            <option value="1406">Century 21 Presidio</option>
            <option value="53">Century 21 Prima</option>
            <option value="12242">Century 21 Prima Arcade</option>
            <option value="89">Century 21 Primagold</option>
            <option value="8234">Century 21 Primera</option>
            <option value="662">Century 21 Quantum</option>
            <option value="9734">Century 21 Sapphire</option>
            <option value="8213">Century 21 Satria</option>
            <option value="1541">Century 21 Star</option>
            <option value="8228">Century 21 Top</option>
            <option value="1286">Century 21 Victory</option>
            <option value="5444">Century 21 Westpoint</option>
            <option value="9098">Century 21 Wiltop</option>
            <option value="12128">Century 21 Zawa</option>
            <option value="10688">Century21 Best</option>
            <option value="7802">Century21 City</option>
            <option value="12377">Century21 Grande</option>
            <option value="11237">Century21 Green</option>
            <option value="11240">Century21 Green Mansion</option>
            <option value="12503">Century21 Hebat</option>
            <option value="11243">Century21 Mandiri</option>
            <option value="866">Century21 Metro 1</option>
            <option value="8240">Century21 Orchid</option>
            <option value="12581">Century21 Prioritas</option>
            <option value="788">Century21 Puri</option>
            <option value="9308">Century21 Rudang Mayang</option>
            <option value="3110">Century21 The Icon</option>
            <option value="98">CH Property</option>
            <option value="7460">Champion 1 Property Bintaro Jaya</option>
            <option value="6002">Champion Property</option>
            <option value="10568">Champion Property Surabaya</option>
            <option value="9530">Channery Property</option>
            <option value="10034">Chika Property</option>
            <option value="3320">CHRISTINA REALTY</option>
            <option value="9743">Cipta Nuansa Properti</option>
            <option value="10874">Circle 21 Property</option>
            <option value="11018">Citipro</option>
            <option value="8630">Citra Sarana Mulia</option>
            <option value="12527">CitraGran Cibubur</option>
            <option value="6389">Citraproperty</option>
            <option value="8570">City Home</option>
            <option value="10160">City Realty</option>
            <option value="71">CITYZONE PROPERTY</option>
            <option value="1649">Classy Property</option>
            <option value="8648">CMP Property</option>
            <option value="908">Coin Property</option>
            <option value="338">Coldwell Banker Gracia</option>
            <option value="2216">Coldwell Banker Radiant</option>
            <option value="119">Confident Property</option>
            <option value="6911">Crown Property</option>
            <option value="12146">D &amp; D Corporation</option>
            <option value="1109">D Property</option>
            <option value="9626">d' One Realty</option>
            <option value="12254">d'berli property</option>
            <option value="8774">d'best home Property</option>
            <option value="11486">D'Gratias Property</option>
            <option value="8873">D'Green Property</option>
            <option value="7844">D'Key Property</option>
            <option value="1595">d'Marvins Property Agent</option>
            <option value="7745">d'mitraproperty</option>
            <option value="9632">D'property Kemang</option>
            <option value="12212">d'RHEIN Property</option>
            <option value="3458">D3fani Property Agent</option>
            <option value="7559">Danartha Property</option>
            <option value="9335">Dandis Property</option>
            <option value="10862">DanielHomes</option>
            <option value="11270">Data Property</option>
            <option value="5735">David Property</option>
            <option value="10025">DC Brothers Property</option>
            <option value="9701">Deal Property</option>
            <option value="11300">Deasy One Property</option>
            <option value="7592">Destana Property</option>
            <option value="7151">Destiny Home</option>
            <option value="9200">DGriya Kedoya Property Agent</option>
            <option value="12284">DIMERSIA Property</option>
            <option value="6707">Diva Property</option>
            <option value="8957">Diva Realty</option>
            <option value="8777">Diva Realty Bintaro</option>
            <option value="7817">DJ Property</option>
            <option value="215">DJOGJA PROPERTY</option>
            <option value="419">DKIA Property</option>
            <option value="7400">Dody Hariawan Property</option>
            <option value="9392">Double S Property</option>
            <option value="9206">Dream Home Property</option>
            <option value="59">Dream House Cinere</option>
            <option value="1151">DREAM REALTY</option>
            <option value="6053">Dream Team Property</option>
            <option value="6179">Dreamland Solo Property</option>
            <option value="12413">Dunamis Property</option>
            <option value="356">Dunia Property</option>
            <option value="12605">Dunia Property Puri Indah</option>
            <option value="7175">Duta Pro</option>
            <option value="8183">Duta Property</option>
            <option value="1871">Duta Property Pondok Indah</option>
            <option value="80">Duta Property Sentul</option>
            <option value="12077">Duta Property.</option>
            <option value="12422">Dynamics Property</option>
            <option value="8156">Eagle Tree Property</option>
            <option value="9212">Eastons Cengkareng</option>
            <option value="12512">Eastons Kelapa Gading Boulevard</option>
            <option value="6611">Eastons Kemang</option>
            <option value="6617">Eastons Pantai Indah Kapuk</option>
            <option value="6557">Eastons Pluit</option>
            <option value="6536">Eastons Pondok Indah</option>
            <option value="6956">Eastons Puri Indah</option>
            <option value="10043">Eastons Semarang</option>
            <option value="8915">Eastons Sunter</option>
            <option value="650">Easy Property</option>
            <option value="6866">Eco Properties</option>
            <option value="8795">Edelweis Property Agent</option>
            <option value="12401">Eden Properti</option>
            <option value="12287">Eka Property</option>
            <option value="12149">Elegant Real Estate</option>
            <option value="9329">Elleprop</option>
            <option value="12593">ELS PRO</option>
            <option value="12548">Ema Realty</option>
            <option value="6212">Embrio Property</option>
            <option value="152">Emerald Property</option>
            <option value="7589">Emerald Real Estate Agent</option>
            <option value="5636">ERA</option>
            <option value="65">ERA Agung Prawira</option>
            <option value="12167">ERA Arta</option>
            <option value="6566">ERA Arya</option>
            <option value="9908">ERA Atlas</option>
            <option value="1805">ERA Bandung</option>
            <option value="422">ERA Best</option>
            <option value="9617">ERA Bima Sakti</option>
            <option value="701">ERA Bintaro</option>
            <option value="6629">ERA Blessing</option>
            <option value="10946">ERA Cipta</option>
            <option value="11585">ERA City</option>
            <option value="4580">ERA Commerce</option>
            <option value="695">ERA Corvilla</option>
            <option value="2174">ERA Ekspres</option>
            <option value="7019">ERA Ekspres Bekasi Branch</option>
            <option value="10199">ERA Fajar Bogor</option>
            <option value="6101">ERA Family</option>
            <option value="6140">ERA Galaxy</option>
            <option value="12590">ERA Galaxy Kertajaya</option>
            <option value="12410">ERA Gold Solo</option>
            <option value="371">ERA Graha</option>
            <option value="12602">ERA Grande</option>
            <option value="7931">ERA Gratia</option>
            <option value="1034">ERA Griya Selaras</option>
            <option value="8012">ERA Griya Selaras BSD</option>
            <option value="5588">ERA Hoki</option>
            <option value="743">ERA Home</option>
            <option value="12551">ERA House</option>
            <option value="12560">ERA Inten</option>
            <option value="12023">ERA Jatim Spazio Branch</option>
            <option value="9608">ERA Jatimrealty</option>
            <option value="7886">ERA Kusuma</option>
            <option value="731">ERA Laksana</option>
            <option value="5357">ERA Land</option>
            <option value="128">ERA Maestro</option>
            <option value="12320">ERA Mas Manado</option>
            <option value="9083">ERA Max</option>
            <option value="2264">ERA Max Cibubur</option>
            <option value="6815">ERA Max Kebayoran</option>
            <option value="6215">ERA Max MTS</option>
            <option value="7988">ERA Max Pancoran</option>
            <option value="1196">ERA Max Serpong</option>
            <option value="8813">ERA Mega Manado</option>
            <option value="12134">ERA Mentari</option>
            <option value="917">ERA Metta</option>
            <option value="5780">ERA Mira</option>
            <option value="6221">ERA Multi</option>
            <option value="12059">ERA Nyoto</option>
            <option value="638">ERA Odelia</option>
            <option value="7538">ERA Odelia Kebon Jeruk Branch</option>
            <option value="9080">ERA One</option>
            <option value="10823">ERA Paradise</option>
            <option value="12572">ERA Peak</option>
            <option value="581">ERA Permata Senayan</option>
            <option value="323">ERA Pratama</option>
            <option value="3836">Era Premier</option>
            <option value="8900">ERA Prima 1</option>
            <option value="7541">ERA Prospek</option>
            <option value="362">ERA Radiant</option>
            <option value="5804">ERA Radiant Alam Sutera</option>
            <option value="9614">ERA Sieto</option>
            <option value="2600">ERA Star</option>
            <option value="10220">ERA Success</option>
            <option value="5366">ERA Susila</option>
            <option value="9620">ERA Tjandra East</option>
            <option value="506">ERA Tjandra South</option>
            <option value="6623">ERA Top Kintamani Branch</option>
            <option value="6992">ERA Top Pantai Mutiara</option>
            <option value="3854">ERA Top Semanan</option>
            <option value="803">ERA Trust</option>
            <option value="12563">ERA Uno</option>
            <option value="110">ERA Victoria</option>
            <option value="218">ERA Victoria Alam Sutera</option>
            <option value="9950">ERA Victoria BO Alam Sutera</option>
            <option value="9947">ERA Victoria BO BSD</option>
            <option value="647">ERA Victoria BO PI</option>
            <option value="9944">ERA Victoria BO Tebet</option>
            <option value="9953">ERA Victoria Kebayoran Baru</option>
            <option value="6107">ERA Victory Bali</option>
            <option value="2900">ERA Vigo</option>
            <option value="12224">ERA Vision</option>
            <option value="12506">Ergo Home</option>
            <option value="9533">Everland Property</option>
            <option value="6755">Excellent Property</option>
            <option value="9911">Exist Property Alam Sutera</option>
            <option value="9851">Exist Property BSD City</option>
            <option value="10208">Exist Property Gading Serpong</option>
            <option value="1769">F &amp; R Property</option>
            <option value="12332">F1RST Property</option>
            <option value="8462">Family Pro</option>
            <option value="6656">Famous&amp;Value Property</option>
            <option value="6383">Farrel Realty</option>
            <option value="8135">Fasyalu Propertindo</option>
            <option value="12425">Ferdi Property</option>
            <option value="5552">FIDESKA</option>
            <option value="8576">FIK Property</option>
            <option value="437">First Choice Kelapa Gading</option>
            <option value="5219">First Choice Kemang</option>
            <option value="6698">First Choice Serpong</option>
            <option value="617">First Galaxy</option>
            <option value="8285">Five Zone Property</option>
            <option value="5375">Focus Property</option>
            <option value="7985">Fortuna Property</option>
            <option value="8825">Fortune Property</option>
            <option value="449">FRAN RUIZ Property</option>
            <option value="12173">Futura Property</option>
            <option value="10547">Future Property</option>
            <option value="254">Gading Pro</option>
            <option value="12497">Gallery Property</option>
            <option value="12260">Gemilang Property</option>
            <option value="188">Genta Gemilang Property</option>
            <option value="12494">GHM Property</option>
            <option value="6500">Global</option>
            <option value="8003">Global Propertindo</option>
            <option value="12299">Global Property</option>
            <option value="146">Global Property Cibubur</option>
            <option value="6881">Glory Realty</option>
            <option value="12179">Golden East</option>
            <option value="10934">Golden Home</option>
            <option value="12446">Golden Home Property</option>
            <option value="9866">Golden Property</option>
            <option value="12281">Golden Property Cibubur</option>
            <option value="7067">GOLDSMITH Property Agent</option>
            <option value="2459">Good Property</option>
            <option value="2591">Goodnews Property</option>
            <option value="11090">GOODWILL PRO</option>
            <option value="5399">Google Property</option>
            <option value="5495">Google Property Kelapa Gading</option>
            <option value="12536">Grace Property Gading Serpong</option>
            <option value="8585">Gracia Propertindo</option>
            <option value="7697">Gracia Property</option>
            <option value="3716">Graha Property</option>
            <option value="2588">Grahapro</option>
            <option value="10724">Grand Central Pro</option>
            <option value="5">Grand Hermon Property</option>
            <option value="8198">Grand Property</option>
            <option value="12419">Grand Realty</option>
            <option value="10976">Grand Royal Property</option>
            <option value="10640">Grand Tamansari Samarinda</option>
            <option value="116">Grandhill Property Agent</option>
            <option value="8531">Grass Property</option>
            <option value="12500">Great Property</option>
            <option value="4124">Greater House</option>
            <option value="12182">Green House Property</option>
            <option value="6335">Green Property</option>
            <option value="12155">GreenLand Property</option>
            <option value="3890">Griya 99</option>
            <option value="3983">Griya Kalimalang</option>
            <option value="8858">Griya Point Property</option>
            <option value="4322">Griya Property</option>
            <option value="62">Griya Sena</option>
            <option value="7784">Grow Property</option>
            <option value="8612">Growin Realty</option>
            <option value="10925">Gudang Property</option>
            <option value="9545">H PRO</option>
            <option value="11498">Hadiwinata Real Estate</option>
            <option value="12530">Handys Home &amp; Land</option>
            <option value="7226">Happy Property</option>
            <option value="12161">Happy Property Bekasi</option>
            <option value="5744">Harcourts</option>
            <option value="2819">Harcourts Alam Sutera</option>
            <option value="6983">Harcourts Bali</option>
            <option value="305">Harcourts Bandung</option>
            <option value="1706">Harcourts Bintaro</option>
            <option value="5078">Harcourts BSD City</option>
            <option value="6419">Harcourts Central BSD</option>
            <option value="12062">Harcourts Denpasar</option>
            <option value="6620">Harcourts Duta Merlin</option>
            <option value="1910">Harcourts Gading Serpong</option>

            <option value="7835">Trust Properti Bandung</option>
            <option value="7139">Trust Property Bintaro</option>
            <option value="557">Tunas Realty</option>
            <option value="155">Two Seasons Tanjung Duren</option>
            <option value="224">TwoSeasonS Puri Indah</option>
            <option value="7097">Ubud Property</option>
            <option value="9752">Ultimate Property</option>
            <option value="12356">UNiHOUSE Sunter</option>
            <option value="9611">Unique Property</option>
            <option value="6047">United Property</option>
            <option value="6761">Unity 21 Property</option>
            <option value="11117">UP Real Property</option>
            <option value="293">V - PROPERTY</option>
            <option value="8114">Va's Property</option>
            <option value="83">Valen Property</option>
            <option value="12455">Value Pro</option>
            <option value="3353">VALUE Property</option>
            <option value="380">Valvin Property</option>
            <option value="6494">VD Realty</option>
            <option value="10421">Vermogens</option>
            <option value="9215">Verona Property</option>
            <option value="8351">VICI Pro</option>
            <option value="11693">Victoria Homes</option>
            <option value="3602">Victory Property</option>
            <option value="7925">Victory Property Real Estate Agent</option>
            <option value="12533">Violet Property</option>
            <option value="6302">Visi Pro</option>
            <option value="6422">Vision1</option>
            <option value="8561">VMpro</option>
            <option value="5585">VVIP Property</option>
            <option value="2663">WakhasaPro</option>
            <option value="3266">Warehouse Property</option>
            <option value="7628">Wasindo Property</option>
            <option value="7277">WD Property</option>
            <option value="9932">Wharna Property</option>
            <option value="1931">White House Property</option>
            <option value="10850">White Property</option>
            <option value="1940">Widya Propertindo</option>
            <option value="1106">Wika Realty</option>
            <option value="12584">WIN Property Gading Serpong</option>
            <option value="6554">Wina Property</option>
            <option value="8930">Wira Brothers Property</option>
            <option value="6176">Wisata Property Cibubur</option>
            <option value="7514">Wonderland</option>
            <option value="12362">X Property</option>
            <option value="8783">XL Property</option>
            <option value="7085">Xynergy Realty</option>
            <option value="8009">YD Property</option>
            <option value="269">Yes Property</option>
            <option value="5954">YOW Property</option>
            <option value="8174">Yun Property</option>
        </select>
        <br/></label>
    <?php echo form_error('job_title'); ?>
    <label for="job_title">
        <b>Pekerjaan:</b>
        <input name="job_title" maxlength="40" type="text" id="job_title" value="<?php echo set_value('job_title'); ?>"/><br/></label>
    <h3>Informasi Pribadi</h3>
    <?php echo form_error('title'); ?>
    <label for="title">
        <b><span class="req">*</span>Titel:</b>
        <select name="title">
            <option value="">[pilih]</option>
            <option value="Bapak">Bapak</option>
            <option value="Ibu">Ibu</option>
            <option value="Tuan">Tuan</option>
            <option value="Nona">Nona</option>
        </select>
        <br/></label>
    <?php echo form_error('nama_depan'); ?>
    <label for="nama_depan">
        <b><span class="req">*</span>Nama depan:</b>
        <input name="nama_depan" maxlength="40" type="text" id="nama_depan" value="<?php echo set_value('nama_depan'); ?>"/><br/></label>
    <?php echo form_error('nama_belakang'); ?>
    <label for="nama_belakang">
        <b><span class="req">*</span>Nama belakang:</b>
        <input name="nama_belakang" maxlength="40" type="text" id="nama_belakang" value="<?php echo set_value('nama_belakang'); ?>"/><br/></label>
    <?php echo form_error('birthday'); ?>
    <label for="birthday">
        <b><span class="req">*</span>Tanggal lahir:</b>
        <input type="text" name="birthday" id="datepicker" value="<?php echo set_value('birthday'); ?>"/>
        <!--
        <select name="birthDay">
            <option value="1">01</option>
            <option value="2">02</option>
            <option value="3">03</option>
            <option value="4">04</option>
            <option value="5">05</option>
            <option value="6">06</option>
            <option value="7">07</option>
            <option value="8">08</option>
            <option value="9">09</option>
            <option value="10">10</option>
            <option value="11">11</option>
            <option value="12">12</option>
            <option value="13">13</option>
            <option value="14">14</option>
            <option value="15">15</option>
            <option value="16">16</option>
            <option value="17">17</option>
            <option value="18">18</option>
            <option value="19">19</option>
            <option value="20">20</option>
            <option value="21">21</option>
            <option value="22">22</option>
            <option value="23">23</option>
            <option value="24">24</option>
            <option value="25">25</option>
            <option value="26">26</option>
            <option value="27">27</option>
            <option value="28" selected="selected">28</option>
            <option value="29">29</option>
            <option value="30">30</option>
            <option value="31">31</option>
        </select>
        <select name="birthMonth">
            <option value="01">January</option>
            <option value="02">February</option>
            <option value="03">March</option>
            <option value="04">April</option>
            <option value="05">May</option>
            <option value="06">June</option>
            <option value="07" selected="selected">July</option>
            <option value="08">August</option>
            <option value="09">September</option>
            <option value="10">October</option>
            <option value="11">November</option>
            <option value="12">December</option>
        </select>
        <select name="birthYear">
            <option value="1900">1900</option>
            <option value="1901">1901</option>
            <option value="1902">1902</option>
            <option value="1903">1903</option>
            <option value="1904">1904</option>
            <option value="1905">1905</option>
            <option value="1906">1906</option>
            <option value="1907">1907</option>
            <option value="1908">1908</option>
            <option value="1909">1909</option>
            <option value="1910">1910</option>
            <option value="1911">1911</option>
            <option value="1912">1912</option>
            <option value="1913">1913</option>
            <option value="1914">1914</option>
            <option value="1915">1915</option>
            <option value="1916">1916</option>
            <option value="1917">1917</option>
            <option value="1918">1918</option>
            <option value="1919">1919</option>
            <option value="1920">1920</option>
            <option value="1921">1921</option>
            <option value="1922">1922</option>
            <option value="1923">1923</option>
            <option value="1924">1924</option>
            <option value="1925">1925</option>
            <option value="1926">1926</option>
            <option value="1927">1927</option>
            <option value="1928">1928</option>
            <option value="1929">1929</option>
            <option value="1930">1930</option>
            <option value="1931">1931</option>
            <option value="1932">1932</option>
            <option value="1933">1933</option>
            <option value="1934">1934</option>
            <option value="1935">1935</option>
            <option value="1936">1936</option>
            <option value="1937">1937</option>
            <option value="1938">1938</option>
            <option value="1939">1939</option>
            <option value="1940">1940</option>
            <option value="1941">1941</option>
            <option value="1942">1942</option>
            <option value="1943">1943</option>
            <option value="1944">1944</option>
            <option value="1945">1945</option>
            <option value="1946">1946</option>
            <option value="1947">1947</option>
            <option value="1948">1948</option>
            <option value="1949">1949</option>
            <option value="1950">1950</option>
            <option value="1951">1951</option>
            <option value="1952">1952</option>
            <option value="1953">1953</option>
            <option value="1954">1954</option>
            <option value="1955">1955</option>
            <option value="1956">1956</option>
            <option value="1957">1957</option>
            <option value="1958">1958</option>
            <option value="1959">1959</option>
            <option value="1960">1960</option>
            <option value="1961">1961</option>
            <option value="1962">1962</option>
            <option value="1963">1963</option>
            <option value="1964">1964</option>
            <option value="1965">1965</option>
            <option value="1966">1966</option>
            <option value="1967">1967</option>
            <option value="1968">1968</option>
            <option value="1969">1969</option>
            <option value="1970">1970</option>
            <option value="1971">1971</option>
            <option value="1972">1972</option>
            <option value="1973">1973</option>
            <option value="1974">1974</option>
            <option value="1975">1975</option>
            <option value="1976">1976</option>
            <option value="1977">1977</option>
            <option value="1978">1978</option>
            <option value="1979">1979</option>
            <option value="1980">1980</option>
            <option value="1981">1981</option>
            <option value="1982">1982</option>
            <option value="1983">1983</option>
            <option value="1984">1984</option>
            <option value="1985">1985</option>
            <option value="1986">1986</option>
            <option value="1987">1987</option>
            <option value="1988">1988</option>
            <option value="1989">1989</option>
            <option value="1990">1990</option>
            <option value="1991">1991</option>
            <option value="1992">1992</option>
            <option value="1993">1993</option>
            <option value="1994">1994</option>
            <option value="1995">1995</option>
            <option value="1996">1996</option>
            <option value="1997">1997</option>
            <option value="1998">1998</option>
            <option value="1999">1999</option>
            <option value="2000">2000</option>
            <option value="2001">2001</option>
            <option value="2002">2002</option>
            <option value="2003">2003</option>
            <option value="2004">2004</option>
            <option value="2005">2005</option>
            <option value="2006">2006</option>
            <option value="2007">2007</option>
            <option value="2008">2008</option>
            <option value="2009">2009</option>
            <option value="2010">2010</option>
            <option value="2011">2011</option>
            <option value="2012">2012</option>
            <option value="2013" selected="selected">2013</option>
        </select>
        -->
        <br/></label>
    <?php echo form_error('email'); ?>
    <label for="email">
        <b><span class="req">*</span>Alamat Email:</b>
        <input name="email" maxlength="100" type="text" id="email" value="<?php echo set_value('email'); ?>"/><br/></label>
    <?php echo form_error('username'); ?>
    <label for="username">
        <b><span class="req">*</span>Username:</b>
        <input name="username" maxlength="100" type="text" id="username" value="<?php echo set_value('username'); ?>"/><br/></label>
    <?php echo form_error('no_hp'); ?>
    <label for="no_hp">
        <b><span class="req">*</span>Nomor ponsel:</b>
        <select name="mobile_country">
            <option value="62">Indonesia (+62)</option>
            <option value="0">Lainnya (+)</option>
        </select>
        <input type="text" style="width:120px" name="no_hp" maxlength="20" id="no_hp" value="<?php echo set_value('no_hp'); ?>" placeholder="8123456789"/>
    </label>
    <?php echo form_error('no_telpon'); ?>
    <label for="no_telpon">
        <b><span class="req">*</span>Nomor telepon:</b>
        <input type="text" style="width:120px" name="no_telpon" maxlength="20" id="no_telpon" value="<?php echo set_value('no_telpon'); ?>" placeholder="021123456789"/>
    </label>
    <?php echo form_error('fax'); ?>
    <label for="fax">
        <b><span class="req">*</span>Nomor fax:</b>
        <input type="text" style="width:120px" name="fax" maxlength="20" id="fax" value="<?php echo set_value('fax'); ?>" placeholder="021987654321"/>
    </label>
    <?php echo form_error('pin_bb'); ?>
    <label for="pin_bb">
        <b><span class="req"></span>Blackberry PIN:</b>
        <input type="text" style="width:120px" name="pin_bb" maxlength="20" id="pin_bb" value="<?php echo set_value('pin_bb'); ?>" />
    </label>
    <?php echo form_error('provinsi'); ?>
    <label for="provinsi">
        <b><span class="req">*</span>Propinsi</b>
        <select name="provinsi">
            <option value="">[pilih]</option>
            <option value="IDJK">DKI Jakarta</option>
            <option value="IDBA">Bali</option>
            <option value="IDBT">Banten</option>
            <option value="IDBE">Bengkulu</option>
            <option value="IDYO">DI Yogyakarta</option>
            <option value="IDGO">Gorontalo</option>
            <option value="IDJA">Jambi</option>
            <option value="IDJB">Jawa Barat</option>
            <option value="IDJT">Jawa Tengah</option>
            <option value="IDJI">Jawa Timur</option>
            <option value="IDKB">Kalimantan Barat</option>
            <option value="IDKS">Kalimantan Selatan</option>
            <option value="IDKT">Kalimantan Tengah</option>
            <option value="IDKI">Kalimantan Timur</option>
            <option value="IDBB">Kep. Bangka Belitung</option>
            <option value="IDKR">Kep. Riau</option>
            <option value="IDLA">Lampung</option>
            <option value="IDMA">Maluku</option>
            <option value="IDMU">Maluku Utara</option>
            <option value="IDAC">Nanggroe Aceh Darussalam</option>
            <option value="IDNB">Nusa Tenggara Barat</option>
            <option value="IDNT">Nusa Tenggara Timur</option>
            <option value="IDPA">Papua</option>
            <option value="IDPB">Papua Barat</option>
            <option value="IDRI">Riau</option>
            <option value="IDSR">Sulawesi Barat</option>
            <option value="IDSN">Sulawesi Selatan</option>
            <option value="IDST">Sulawesi Tengah</option>
            <option value="IDSG">Sulawesi Tenggara</option>
            <option value="IDSA">Sulawesi Utara</option>
            <option value="IDSB">Sumatera Barat</option>
            <option value="IDSS">Sumatera Selatan</option>
            <option value="IDSU">Sumatera Utara</option>

        </select>
    </label>
    <?php echo form_error('kota_kab'); ?>
    <label for="kota_kab">
        <b>Kota/Area</b>
        <input type="text" id="city_area" name="kota_kab" maxlength="100" value="<?php echo set_value('kota_kab'); ?>"/>
    </label>

    <p>Silakan masukan kata sandi yang anda pilih. Harus mengandung setidaknya 8 huruf dan/atau angka.</p>
    <div class="clearboth"></div>
    <?php echo form_error('password'); ?>
    <label for="password">
        <b><span class="req">*</span>Kata Sandi:</b>
        <input name="password" maxlength="32" type="password" id="password" value="<?php echo set_value('password'); ?>" /><br/></label>
    <?php echo form_error('password_confirm'); ?>
    <label for="password_confirm">
        <b><span class="req">*</span>Konfirmasi Kata Sandi:</b>
        <input name="password_confirm" maxlength="32" type="password" id="password_confirm" value="<?php echo set_value('password_confirm'); ?>"/><br/>
    </label>
    <br />

    <label for="profil">
        <b>Profil:</b>
        <textarea name="profil" rows="5" cols="100" style="resize:none">

        </textarea>
    </label>

    <label for="pengalaman">
        <b>Pengalaman:</b>
        <textarea name="pengalaman" rows="5" cols="100" style="resize:none">

        </textarea>
    </label>

    <h3>Payment Method</h3>
    <div class="top20 bottom10">
        <p>Silakan pilih metode pembayaran dengan meng-klik lingkaran yang relevan di sebelah kiri:</p>

        <div class="mleft50">
            <input name="payment" type="radio" value="1" /> <b>Cash</b><br/>
            <input name="payment" type="radio" value="2" /> <b>Cek</b><br/>
            <input name="payment" type="radio" value="3" checked /> <b>Bank Transfer</b><br/>
        </div>

        <p>
            Rumah.com akun Agen Premium anda akan diaktifkan dengan penerimaan pembayaran. Kami akan email detail username dan kata sandi dengan Rumah.com User Guide
        </p>
        <div class="buttons">
            <input class="btnredsmall" type="submit" value="Next Step" name="submit">
        </div>
    </div>
    <div class="info mtop10">Catatan: Kami sangat menghormati kerahasiaan pengguna. Kami tidak akan memberikan kontak informasi anda pada pihak ke-3 atau mengirim anda komunikasi apapun tanpa izin tertulis dari anda.
        Silakan mengacu pada <a href="/privacy" class="bluethinlink">Kebijakan Privasi</a> untuk informasi lebih lengkap tentang penggunaan detail registrasi.
    </div>
</form>
